Lecture 2

Question 1

Before pregnancy

Answer 1

Increasing evidence demonstrating that parents diet and lifestyle can have profound implications for the growth, development, and long-term health of their children before their conception.

Question 2

What has a big influence on the placental development and function

Answer 2

The maternal nutrition at the time of conception

Question 3

what is directly tied to maternal periconception

Answer 3

Fetal genomic imprinting and programming at conception is directly tied to maternal periconception nutrition and childs long term health

Question 4

Preconception time frame

Answer 4

The period before (at least 2 years) and between consecutive pregnancies.

Question 5

What does Preconception improve

Answer 5

To improve health related outcome for women (regardless of their pregnancy status), newborns and children up to 5 years of age.

Question 6

Boundary of preconception is divided into

Answer 6

Proximal and distal period

Question 7

Proximal preconception

Answer 7

Period preceding pregnancy (up to 2 years prior to conception

Question 8

Distal preconception

Answer 8

Adolescence or in general a longer time before pregnancy

Question 9

Periconception time frame

Answer 9

The period preceding, including and immediately following human conception

Question 10

what does periconception improve

Answer 10

to improve health related outcomes for women, newborns and children up to 5 years

Question 11

Periconception boundary

Answer 11

3 months before pregnancy to up to the first trimester

Question 12

Criticial window of opportunity (5 stages)

Answer 12

• Pre conception
• Pregnancy
• Birth- 6 months
• 6-12 months
• 1-3 years

Question 13

Number of days for critical window

Answer 13

First 1000 days of life= Critical window

Question 14

Nutrition during pregnancy and the two years of the childs life is key for

Answer 14

brain development, healthy growth and a strong immune system

Question 15

The 5 steps to periconception period

Answer 15

Gametogensis
Fertilisation
Implantation
Embryogenesis
Placentation

Question 16

what are the 5 important factors that we need to keep in mind for a health status

Answer 16

-Optimise Health
-Folic acid
-Iodine
-Healthy diet and lifetyle
-Excess weight

Question 17

Optimise Health

Answer 17

Ensure any existing health conditions are being treated and managed

Question 18

Folic acid

Answer 18

Supplement at least a month before trying to conceive

Question 19

Iodine

Answer 19

Supplement if planning to conceive

Question 20

Healthy Diet and lifestyle

Answer 20

Follow a healthy diet and lifestyle and cease smoking

Question 21

Excess weight

Answer 21

Reduce excess weight for both men and women

Question 22

Obesity generally indicated by a BMI

Answer 22

> 30 kg/ m^2

Question 23

Are Obese men and women infertile or sub-fertile

Answer 23

Subfertile

Question 24

Obese women tend to have higher levels of

Answer 24

estrogen, androgens and leptin than non-obese

Question 25

By how much more of a percent is menstrual cycle irregularity in obese women as well as

Answer 25

30-47% ovulatory failure and amenorrhea

Question 26

Obesity in men is associated with lower levels of

Answer 26

Testosterone and increased estrogen and leptin levels

Question 27

What are two other things that are increased for obese men

Answer 27

Reduced sperm production and increased erectile dysfunction

Question 28

weight loss exceeding 10-15% decreases

Answer 28

estrogen, LH and FSH

Question 29

what is the critical body fat which can sustain normal reproductive functions

Answer 29

BMI >20 kg /m^2

Question 30

Long term consequences of undernutrition on fertility and offspring health revealed during country famines

Answer 30

Dutch famin in 1944-45

Question 31

Periconception and the important micronutrients that need to be considered (7)

Answer 31

Choline Iron Iodine Zinc Omega 3 fatty acids and B12 Multivitamins Folic acid

Question 32

Folic acid

Answer 32

Neural tube defects Congenital Malformations Preeclampsia Autism Spectrum Disorder Increased sperm count and viability

Question 33

Periconceptional folic acid

Answer 33

2010 Cochrane review confirmed that folic acid supplementation prevents the first and second time occurence of neural tube defects

Question 34

Neural tube defects happen

Answer 34

even before some women even know they are pregnant

Question 35

If you are planning a pregnancy you need to take how much folic acid

Answer 35

Take 800mcg folic acid tablet at least 4 wks before and 12 wks after becoming pregnant

Question 36

Women who ten to take folic acid are people of a

Answer 36

higher education, higher income, older age, NZ European

Question 37

Unplanned pregnancies

Answer 37

40% mistimed 60% Unwanted

Question 38

Folic acid fortification

Answer 38

Over 80 countries have introduced mandatory folic acid fortification

Question 39

Mandatory folic acid fortification in what in NZ

Answer 39

Bread

Question 40

Bread increases the folic acid amount per day and Decreases the chance of

Answer 40

136ug folic acid per day to women of childbearing age expected to reduce the annual rate of NTD-affected pregnancies between 4 to 14

Question 41

why withdraw from fortification

Answer 41

-Safety concerns -"Nanny" state critics -Bakers worried about the cost and safety

Question 42

There are still concerns for some people in what categories not getting enough folic acid

Answer 42

No gain for individuals with wheat allergy or coeliac disease

Question 43

Dutch famine = Hunger winter

Answer 43

Famine that took plave in the German ossipied part of the Netherlands especially in the densely populated western provinces, during the winter of 1944-45, near the end of world war II

Question 44

The dutch famine found that children of pregnant women exposed to the famine were more

Answer 44

susceptible to diabetes, obesity, cardiovascular disease, microalbuminuria and other health problems

Question 45

Children were not only smaller but

Answer 45

Their children were also smaller

Question 46

Barker Hypothesis

Answer 46

The fetal origins hypothesis states that fetal under nutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease

Question 47

New Zealand recommendations supplementation during pregnancy

Answer 47

Folic acid (800ug), iodine (150ug), vitamin D and Iron Only take other supplements on the advice of a doctor or midwife